Annals of emergency medicine
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Noninvasive ventilation (NIV) is the provision of ventilatory support to a spontaneously breathing patient without endotracheal intubation. In this review, we detail concerns related to endotracheal intubation and summarize the physiologic effects and clinical application of NIV. We then address the use of NIV in 5 conditions of particular interest to the practitioner of emergency medicine: exacerbated chronic obstructive lung disease, severe asthma, patients who are not candidates for endotracheal intubation, pneumonia, and pulmonary edema.
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To determine the effectiveness, safety, and resource allocation of a 2-specialty, 2-tiered triage and trauma team activation protocol. ⋯ This evaluation tool effectively predicts likelihood of serious injury, mortality, need for emergency surgery, and need for rehabilitation. Patients with a low likelihood of serious injury may be initially evaluated by the emergency medicine service effectively and safely, thus allowing more efficient use of surgical personnel.
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We present 2 cases in which the transfusion of small volumes of packed RBC was sufficient to precipitate symptomatic hypocalcemia. Subsequent inquiry revealed that both of the patients had preexisting, untreated, and asymptomatic hypocalcemia, 1 following partial thyroidectomy many years earlier and the other with documented hypocalcemia but without a definitive diagnosis.
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Now a member of the Commonwealth of Independent States, Kazakhstan is the second largest of the republics that made up the former Soviet Union. This report describes the structure of the health care system in Kazakhstan, with particular emphasis on emergency medicine. It examines medical education, the organization of health care services, emergency medical services, emergency department structure, and the challenges facing emergency medicine.
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To measure the interrater and intrarater agreement of existing emergency department triage systems. ⋯ Triage assessments (both interrater and intrarater) by experienced personnel are inconsistent using these 5 standardized patient scenarios. These results challenge the reliability of current ED triage practice.